摘要
血清－腹水白蛋白梯度（ＳＡＡＧ）是间接反映门静脉压力的一个指标，曾用于良恶性腹水的鉴别诊断。为探讨其对良恶性腹水的鉴别价值，本文对６４例各种病因的腹水患者作ＳＡＡＧ测定。结果显示，肝硬化组ＳＡＡＧ为２５．４４±７．２２ｇ／Ｌ，而腹腔癌组为５．５４±３．１２ｇ／Ｌ两组差异有显著意义（Ｐ＜０．００１）。ＳＡＡＧ鉴别肝硬化与腹腔癌的准确性达９７．９％，但由于肝癌组ＳＡＡＧ亦增大，与肝硬化组相近（Ｐ＞０．０５），而结核性腹水和心源性腹水ＳＡＡＧ则小，与腹腔癌组相近，ＳＡＡＧ鉴别良恶性腹水的准确性降为７９．７％。因此，ＳＡＡＧ不适于良恶性腹水的鉴别。结核性腹水腺苷脱氨酶明显升高，有助于结核和癌性腹水的鉴别。
Several studies performed in advanced liver diseases have demonstrated a positive correlation between serum-ascites albumin gradient(SAAG) and portal venous pressure,and it was reported that SAAG is a reliable test for differential diagnosis between nonmalignant and malignant ascites.In an effort to confirm these observations,64 patients with ascites were studied:32 with cirrhosis of liver,10 with miscellaneous nonmalignant diseases,15 with peritoneal carcinomatosis and 7 with hepatocellular carcinoma. Results showed that the mean SAAG in peritoneal carcinomatosis group was 5.54±3.12 g/L,which was significantly lower than that in the cirrhosis group(25.44±7.22 g/L;P<0.001).SAAG seperated peritoneal carcinomatosis from cirrhosis with accuracy of 97.9%. However,the mean SAAG in hepatocellular carcinoma was higher and similar to that of cirrhosis while in cardiac ascites and tuberculous peritonitis it was lower and similar to that of peritoneal carcinomatosis.It separated nonmalignant from malignant ascites with accuracy of 79.7%,Therefore,SAAG was not a reliable test to distinguish nonmalignant from malignant ascites,Ascitic fluid concentration of adenosine deaminase(ADA)was significantly higher in tuberculous peritonitis than that of the other ascites.
出处
《胃肠病学和肝病学杂志》
CAS
1994年第3期197-200,共4页
Chinese Journal of Gastroenterology and Hepatology
